Paul Kenneth Stevens, D.O.
Individual provider Active NPI Obstetrics & Gynecology Physician · Twin Falls, ID
NPI 1376809202 · NPPES record last updated Jun 17, 2016
Key facts
- NPI
- 1376809202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- O-0944 (ID)
- Practice address
- 801 Pole Line Rd W
Magic Valley Women'S Health Clinic
Twin Falls, ID 83301-5810 - Phone
- (208) 814-8500
- Fax
- (208) 814-8960
- NPI assigned
- Apr 4, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Lukes Clinic LLC
Practice addresses (Care Compare)
746 N College Rd
Twin Falls, ID 83301-3486
775 Pole Line Rd W
Twin Falls, ID 83301-5823
801 Pole Line Rd W
Twin Falls, ID 83301-5810
Hospital & facility affiliations
- St Lukes Magic Valley Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160728001379 | ID | Practitioner - Obstetrics/Gynecology | 3375774516 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O-0944 | ID | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Clinic LLC | Current |
Accepting new patients | |
| St. Luke'S Magic Valley Regional Medical Center, LTD. | Past | Accepting new patients | |
| St Luke'S Magic Valley Regional Medical Center LTD | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
801 Pole Line Rd W
Ste 3880
Twin Falls, ID 83301
Phone (208) 814-8500
775 Pole Line Rd W
Ste 312
Twin Falls, ID 83301
Phone (208) 814-8600
801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000
801 Pole Line Rd W
Ste 3810
Twin Falls, ID 83301
Phone (208) 814-8500
746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230
Interoperability endpoints
- pstevens48039@direct.slhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | O-0944 | ID | Yes |
Addresses
Primary practice location
801 Pole Line Rd W
Magic Valley Women'S Health Clinic
Twin Falls, ID 83301-5810
Mailing address
801 Pole Line Rd W
Magic Valley Women'S Health Clinic
Twin Falls, ID 83301-5810
Phone (208) 814-8500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376809202 | Other | ID | NPI |
Other providers in Twin Falls, ID
- Tara L Stauffer
- John D Steffens
- Stacy Ann Stephens
- Steppin Stones Therapy PLLC
- Nichole Ruby Stevens
- Alanah Stieg
- Andreya Marie Stiehl
- Stillwater Therapy PLLC
- Stoddard & Bingham Medical of Twin Falls PLLC
- Allison Stokes
All providers in Twin Falls, ID · Obstetrics & Gynecology Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.